Sacroiliac Joint - Laslett tests

• • aims to mechanically stress the joint and ligamentous structures
  • The aim of these tests is purely for pain reproduced as stressing the tissue if sensitive will reproduce a pain response
  • These tests are indicated to help diagnose if the sacroiliac joint is the patient’s source of symptoms or to rule it out
• To differentiate from the Lumbar spine:

  • Lack of lumbar spine impairments and negative lumbar pain on provocation tests
  • The area of pain for the sacroiliac joint will be localised over the posterior superior iliac spine and inferior to the sacroiliac joint
  • The sacroiliac joint can often refer in the buttock, posterior tight and groin
  • It is not common for the sacroiliac joint to refer into the lumbar region, but the lumbar spine can often refer into the sacroiliac joint
  • You may have symptoms from both the Lumbar spine and the sacroiliac joint
• There are 5 tests, and at least 3 need to be positive to indicate the SIJ:

  • Distraction
  • Thigh thrust
  • Gaenslen's
  • Compression
  • Sacral thrust
• Distraction:

  • Pts in supine
  • find lateral aspects of the ASIS
  • use heels of hands to push both of the ASIS together/inwards
  • positive result = pain reproduction

  
• Thigh thrust:

  • pts in supine
  • lower the plinth
  • pts hip in 90 degrees of flexion
  • apply an AP force straight down the femur
  • positive result = pain reproduction

  
• Gaenslen’s:

  • pts in supine, lying nearly diagonally across the plinth
  • one leg is dropped off the bed in hip extension
  • other leg is brought to pts chest (they hold it with their hand) in hip flexion
  • apply over pressure on each leg
  • positive result = pain reproduction

  
• Compression:

  • pts in supine
  • cross your arm
  • apply pressure on medial border of ASIS
  • push outwards
  • positive result = pain reproduction

  
• Sacral thrust:

  • pts in prone
  • find pts sacrum
  • apply a PA force straight downwards
  • positive result = pain reproduction

  
• the pain reproduced in Laslett tests would be somatic pain as its not nerve related
• • the pain reproduced in Laslett tests would be somatic pain as its not nerve related
  • does not refer pain upwards, only refers downwards - posterior thighs and hip joint